Ilene Corina is a long-time patient safety advocate who often sits by patients’ bedsides in hospitals to keep them safe during their hospital stays.
A recent blog post of hers asks the question: when a patient or caregiver hires a patient advocate, what do happens if, despite everyone’s best efforts, the outcomes are negative?
Of course, the answer depends on a number of factors, including the fact that not all advocate services are cut and dried and easy to define.
Further, I have to think that sometimes an advocate is hired with one set of expectations, as understood by the advocate and perhaps even recorded on paper. However I think it’s entirely possible that even though the words say one thing, the patient’s hopes, and unspoken expectations may be something else.
That can be a danger zone for an advocate. Here are some examples:
A cancer patient who is not doing well asks an advocate to find possible clinical trials for him. The advocate finds two possible trials – success, according to their agreement. But is it possible the patient was really hoping the advocate would uncover something else? A drug or a cure – some sort of silver bullet?
A surgery patient hires an advocate to sit by her beside while she stays in the hospital to keep her safe. The advocate considers herself a guardian. She’s all business – fending off non-handwashers and double checking all drugs. But the patient expected a companion, too. Someone to phone her family when necessary, or ooo and ahhh at her grandchildren’s photos.
A couple hires a billing advocate to help reduce the wife’s hospital bill. They’ve read that 80 percent of hospital bills have mistakes and they are hoping to reduce their bill by 50 percent or more. The billing advocate is able to reduce their bill by more than 30 percent. A success, but maybe not successful enough?
So how can you, the advocate, be sure patients have fair and accurate expectations of you and your work?
By managing those expectations clearly, and spelling out potential miscommunications or misunderstandings before you actually begin doing the work. To the best of your ability, try to anticipate where patients might hope something that you can’t or shouldn’t deliver.
Be clear about what you can, and can’t, deliver. Explain clinical trials carefully and be sure your patient doesn’t have unrealistic expectations. Explain to your hospital patient that you’ve brought work with you and she should put her efforts into sleeping and healing – or walking the corridors with the nurse. Explain that your average bill reduction is about 15% so that if you save them 20% they’ll consider themselves above average!
Ilene’s blog post asks what happens when patients hire you for one thing, but get another, negative outcome. I challenge you to take that thought further – to think about what happens when you think you’ve met your obligation, but the patient had unspoken wants that were not met.
So much of your success will be based on how well you manage your clients’ expectations – both defined and undefined. Be sure to address them both.
One strategy Allied Health Advocates tries to do is send a mailed evaluation to all clients. This provides an opportunity for both qualitative (descriptive) and quantitative (on a scale between 1 and 5, with 1 being ‘the best’ and 5 being ‘unacceptable’…) Feedback, so that patients have the opportunity help show us where we can be improving our communication.